Cyproterone acetate in acne

Abstract

Androgens stimulate and estrogens inhibit sebaceous gland activity. The androgenic stimulation is influenced to a variable degree by accelerated peripheral conversion of precursor androgens or by elevated hormone-receptor levels in the target organ sebaceous gland. This has led to the use of cyproterone acetate (CPA) as an antiandrogen in the management of treatment-resistant acne. The oral contraceptive Diane containing 2 mg of CPA and 0.05 mg of ethinylestradiol has proved to be highly effective in several studies reported over the last 15 years. Treatment with CPA is indicated in women with severe inflammatory acne or acne with marked premenstrual exacerbations, as well as in all women with acne who want to use oral contraceptives. With the trend to reduce the estrogen component of oral contraceptives, Diane has been replaced by Diane 35, which contains only 0.035 mg of ethinylestradiol. In a double-blind multicentre study the use of Diane and Diane 35 has been compared for the treatment of acne. Diane...